SOAR REQUEST FOR APPLICATIONS – STATE FUNDSdhhs.ne.gov/Grants and Contract Opportunity Docs/SOAR RFA - Final Draft.pdfPerformance Requirements 1. Grantee must meet or exceed the

1

REQUEST FOR APPLICATIONS ndash STATE FUNDS

The State of Nebraska Department of Health and Human Services Division of Children and Family Services (ldquoDHHSrdquo) Nebraska Homeless Assistance Program (ldquoNHAPrdquo) is issuing this Request for Applications (ldquoRFArdquo) for the purposes of entering into grant agreement(s) (ldquograntrdquo or ldquograntsrdquo) and awarding state funds to an eligible and qualified entity to provide SSISSDI Outreach Access and Recovery (SOAR) services A more detailed description may be found in Project Description Section 2

RFA

2634

RELEASE DATE

April 28 2020 APPLICATION DUE DATE

MAY 26 2020 POINT OF CONTACT

Keith Roland and Jennifer Crouse

INITIAL PERIOD OF PERFORMANCE

JULY 1 2020 ndash JUNE 30 2021

TOTAL FUNDING AVAILABLE

$280000

Grantees receiving grants may only be paid up to the actual and allowable costs (as defined herein) of completing the Project Description Section 2 No Grants resulting from this RFA will be fee-for-service contracts regardless of the method of payment and no Grantee may keep a profit from its grant More detail about the terms of this funding is set forth in Terms Section 5 below

A copy of this RFA may be found online at DHHSrsquo website at wwwdhhsnegov Until final Grants are signed all other information pertinent to this RFA including but not limited to any amendments or addenda will be posted on the DHHS website

Table of Contents

I RFA OVERVIEW 4

Funding 4

Period of Performance 4

Applicable Law 4

Eligible Entities 4

Award of Funding 4

II PROJECT DESCRIPTION 5

Background and Purpose 5

Scope of Work 5

Performance Requirements 5

Reporting Requirements 6

Applicant Requirements 6

III RFA PROCEDURE 7

RFA Point of Contact (ldquoPOCrdquo) 7

Schedule of Events 8

Pre-Applicant Information Session 8

Written Questions and Answers 8

Submission of Applications 9

Evaluation Committee 9

Evaluation of Applications 10

Late Applications 10

Corrections 10

Grievance and Protest Procedures 10

Competition Joint Efforts 11

DHHS Reservations of Authority During Application and Evaluation Process 11

IV APPLICATION INSTRUCTIONS 12

Application Contents 12

Applicantrsquos Organizational Overview 12

Applicantrsquos Work Plan 12

Applicantrsquos Budget 12

V TERMS 14

Addenda 14

Budget Changes 14

Direct Costs 14

Indirect Costs 14

Program Income 14

Records Retention 15

2

Faith-Based Activities 15

VI GLOSSARY OF TERMS 17

3

RFA OVERVIEW

FundingThe total anticipated available funds for Grant(s) under this RFA is $280000 (two hundred eighty thousand dollars] A total award of this amount of funds is not guaranteed but is subject to the Applications received to actual money appropriated to DHHS and to DHHSrsquo discretion DHHS may establish a cap on total amount of funds that any one Applicant or Applicants acting jointly may request Any cap shall be set forth in the Applications Instructions Section 44 below The total funds may be split among multiple Grantees in the discretion of DHHS

Period of Performance The Period of Performance is the time during which a successful Applicant may incur costs to carry out the work authorized under this RFA and the resulting Grant For purposes of this RFA and resulting Grant DHHS will apply the definition of ldquoperiod of performancerdquo in 2 CFR sect 20077 or 45 CFR sect 752 The initial Period of Performance for this RFA is from July 1 2020 to June 30 2021 This period may be extended by DHHS

For the initial Period of Performance all costs must be invoiced to DHHS by July 31 2021 and liquidated (ie spent) by September 15 2021 These dates are dependent on DHHSrsquo own ability to timely process payments They may be subject to change final dates will be included in the final Grant between the parties If an Applicant believes it cannot meet these deadlines it should not apply for funding under this RFA Obligation and liquidation deadlines may be extended but no extensions are guaranteed Future Periods of Performance as allowed by DHHS may have different obligation and liquidation deadlines

Applicable LawFor purposes of this RFA and resulting Grant DHHS will apply the Uniform Grant Guidance in addition to all applicable state law The Uniform Grant Guidance 2 CFR sectsect 200 et seq (ldquoUGGrdquo) generally applies to grants funded from the United States Department of Agriculture (USDA) the Department of Housing and Urban Development (HUD) the Department of Labor (DOL) the Environmental Protection Agency (EPA) or other federal agencies

Additional state statutes and regulations may apply to the funding contained herein These may be included in Additional Program Requirements Section 57 below as well as in the Grant itself

Further information about allowable costs and activities may be set forth herein

Eligible EntitiesAny Applicant for this RFA must be a ldquonon-federal entityrdquo as defined 2 CFR sect 20069 A ldquonon-federal entityrdquo is limited to local governments Indian tribes institutions of higher education or nonprofit organizations further definitions in the UGG may apply Any Application submitted by an Applicant who is ineligible shall be rejected without scoring

Additional requirements for determining the eligibility of entities may also be included in the Project Description

Award of Funding DHHS will evaluate Applications in the manner set forth herein An Intent to Award will be posted on the DHHS Website with selected Applicants Funds will be awarded through a written agreement termed a Grant which will incorporate this RFA by reference No promise for funds is binding on DHHS and no funds will be paid to any Applicant until a Grant has been executed by both the Applicant and DHHS

4

PROJECT DESCRIPTION

Background and PurposeThe purpose of this funding is to assist individuals and individuals at risk of homelessness with applying for Social Security Income (SSI) and Social Security Disability Income (SSDI) by utilizing the SSISSDI Outreach Access and Recovery (ldquoSOARrdquo) model develop by the Substance Abuse and Mental Health Services Administration (ldquoSAMHSArdquo)

Scope of Work Agencies awarded this funding will be the SOAR lead agency within their region In addition to providing one full time staff member to assist with SSISSDI applications using the SOAR methodology agencies will be responsible for educating key stakeholders regarding the SOAR model and for the following

1 Establish new relationships with at least three (3) new stakeholders ie medical clinics hospitals community corrections libraries and local department of labor office

2 Maintain relationships with existing referral providers 3 Establishmaintain a regional SOAR Steering Committee which meetings at least quarterly and is

comprised of local stakeholders 4 Accept referrals from the Continuum of Care and the community 5 Communicate with referring agencies regarding the quality of the referral 6 Communicate with individuals referred to discuss if they qualify for Social Security or Social

Security Disability Insurance and the strength of their medical evidence 7 Complete all paperwork required for the SSISSDI application 8 Coordinate with local health providers to obtain medical records 9 Meet with clients to complete the application either in-person or via video or teleconference 10 Submit an appeal for all SSISSDI applications that are denied 11 Interview former employers family members caseworkers to collect evidence supporting the

individualrsquos inability to maintain work at a Substantial Gainful Activity (SGA) 12 Update SOAR applicants on the status of their application 13 Track completed applications and outcomes in Online Application Tracking 14 Grantee must meet national standards as established by Policy Research Associates Inc (PRA)

including the completion of a Medical Summary Report and a Quality Review Checklist 15 Complete SOAR Online Training provided through PRA Inc This training is free of charge to the

Grantee

Performance Requirements 1 Grantee must meet or exceed the performance measurements provided in tables 1-3 below 2 Grantee must submit required performance measurements in the format established by NHAP on a

quarterly basis or as requested by NHAP 3 At any time during the term of the grant DHHS may require the Grantee to provide written

justification if the performance standards provided in tables 1-3 below are not met 4 Future project funding is subject to Grantee meeting the performance standard or providing

adequate justification subject to DHHS approval

Table 1 - Initial Applications

070120 TO063021

OF SSISSDI INITIAL APPLICATIONS FILED 25

OF SSISSDI INITIAL APPLICATIONS APPROVED 63

AVERAGE OF DAYS TO INITIAL DECISION 108

5

Table 2 - Appeals

070120 TO063021

OF SSISSDI APPEALS APPROVED 42

AVERAGE OF DAYS TO APPEAL DECISION 187

Table 3 - Housing and Employment

070120 TO063021

OF APPLICANTS FOR WHICH BENEFITS FACILITATED ACCESS TO HOUSING

80

INCREASE OF APPLICANTS WORKING AFTER APPROVAL

5

Reporting Requirements 1 Track outreach activities and report those efforts quarterly Reports are due October 15 April 15

January 15 and July 15 2 Track referrals and report outcomes of referrals quarterly Reports are due October 15 April 15

January 15 and July 15 3 Record all completed applications appeals and outcomes in the Online Application Tracking tool

within two (2) Granteersquos business days A link to the Online Application Tracking tool will be provided to Grantees after award

Applicant Requirements 1 Provide a narrative description of the SOAR services to be provided 2 Describe training the Grantee will provide to SOAR case managers 3 Describe the partnerships the Grantee currently has established for SOAR services 4 Provide the region where the Applicant can provide SOAR services Refer to Attachment 1 for a

map of the regions If an Applicant can provide SOAR services in multiple regions the Applicant must submit a separate response to this RFA for each region

6

RFA PROCEDURE This RFA seeks Applications to complete activities allowable under the funding source identified in 12 above All Applications must conform to all instructions conditions and requirements included in this RFA Applicants should carefully examine this RFA as well as the requirements on the state or federal funds involved Applications that DHHS determines do not conform to the requirements of this RFA or Applications from ineligible entities may be considered non-responsive and rejected without scoring

RFA Point of Contact (ldquoPOCrdquo)

Keith Roland and Jennifer Crouse Buyers DHHS Central Procurement Services 301 Centennial Mall South Lincoln NE 68509 (402) 471-0727 DHHSRFAResponsesnebraskagov

From the date the RFA is issued until the Intent to Award is issued communication from the Applicant or prospective Applicant is limited to the POC listed above (but see exceptions below) After the Intent to Award is issued the Applicant may communicate with individuals DHHS has designated as responsible for negotiating the Grant on behalf of DHHS No member of the state government employee of the state or member of the Evaluation Committee is empowered to make binding statements regarding this RFA The POC will issue any clarifications or opinions regarding this RFA in writing Only the POC has the authority modify the RFA answer questions or render opinions on behalf of DHHS Applicants shall not have any communication with or attempt to communicate or influence any Evaluator

The following exceptions to these restrictions are permitted

1 The email submission of the Application to the designated email address designated in Submission of Applications Section 35

2 Contact made pursuant to pre-existing contracts grants or obligations 3 Contact required by the schedule of events or an event scheduled later by the RFA POC and 4 Contact required for negotiation and execution of the final grant

DHHS reserves the right to reject an Applicantrsquos application withdraw an Intent to Award or terminate a Grant if DHHS determines there has been a violation of these procedures

7

8

Schedule of Events

Pre-Applicant Information Session

ACTIVITY DATETIME

1 Release RFA April 28 2020

2 Pre-Applicant Information Session May 5 2020 1000 AM Central Time

3 Last day to submit written questions May 8 2020

4 State responds to written questions through RFA ldquoAddendumrdquo andor ldquoAmendmentrdquo to be posted to the Internet at httpdhhsnegovPagesGrants-and-Contract-Opportunitiesaspx

May 19 2020

5 Application Review Period Begins (Application due date) May 26 2020 200 PM Central Time

6 Evaluation Period June 1 2020 through June 11 2020

7 Post ldquoIntent to Awardrdquo to Internet at httpdhhsnegovPagesGrants-and-Contract-Opportunitiesaspx

June 12 2020

8 Period of Performance Start July 1 2020

The Period of Performance start may occur before a Grant is finalized agreed to and executed by the parties Because this is just the period during which costs may be incurred it does not reflect that any agreement between DHHS and any successful Applicant has gone into effect or is binding in any way No binding agreement has been made between DHHS and any Applicant until a Grant is fully executed by both parties

DHHS will host a Pre-Applicant information session at the date and time listed above Entities that are interested in applying for this RFA may participate via WebEx by having a representative attend

At the Pre-Applicant Information Session the POC or a designated DHHS representative will provide general information about the funding and answer questions from potential Applicants

At the date and time listed above in the Schedule of Events entities can join the WebEx meeting by clicking on the following link

httpsnvcn-ciowebexcomnvcn-ciojphpMTID=m96b8a6fb6387a88846e6cacead63a7ec

Written Questions and Answers Questions regarding information needed for an Application as well as the meaning or interpretation of any RFA provision must be submitted in writing to POC via email and clearly marked ldquoRFA Number 2634 Questionsrdquo The POC is not obligated to respond to questions that are received late as set forth in the Schedule of Events

Applicants should present as questions any assumptions upon which the Application is or might be developed Applications will be evaluated without consideration of any known or unknown assumptions of an Applicant The Grant will not incorporate any known or unknown assumptions of an Applicant

9

Questions must be sent via e-mail to DHHSRFAResponsesnebraskagov DHHS recommends that Applicants submit questions using the following format

RFA Section Reference

RFA Page Number

Question

Written answers will be posted at the DHHS Website per the Schedule of Events Written answers will become part of this RFA

Submission of Applications Applicants must submit a complete Application including all the parts required herein in one of three ways

1 Electronically via email to DHHSRFAResponsesnebraskagov The subject of the email shall indicate ldquoRFA (with the appropriate number filled in) Response of [Name of Organization]rdquo The email shall include the Application as a single Portable Document Format (PDF) or multiple PDFs Failure to provide the Application in the correct format may result in DHHS being unable to read or open the Application and thus rejecting it without Evaluation The email shall request a read receipt A read receipt will be supplied to the Applicants upon receipt of the email by DHHSrsquo Central Procurement Services Central Procurement Services shall not forward the Applications to the program until the beginning of the Application Review Period

2 Submission directly to the POC via United States Postal Service mail The Application shall be sent to the POCrsquos address listed above in Point of Contact Section 31 The Application itself shall remain sealed and shall not be opened until the beginning of the Application Review Period

3 Hand delivered responses or responses delivered by FedEx or UPS should be delivered to

ATTN Keith RolandJennifer Crouse DHHS - 3rd Floor Reception Desk 301 Centennial Mall South Lincoln NE 68509

The Application itself shall remain sealed and shall not be opened until the beginning of the Application Review Period

Regardless of submission method Applicants must use the forms supplied by DHHS in this RFA unless specifically otherwise indicated herein All Applications must be received by the beginning of the Application Review Period as stated in the Schedule of Events Section 32

Evaluation Committee Applications are evaluated by members of an Evaluation Committee(s) The Evaluation Committee(s) will consist of individuals selected at the discretion of DHHS All members of the Evaluation Committee will disclose to DHHS any potential conflicts of interest before evaluation Members with a conflict will be removed from the Evaluation Committee before scoring

Any contact attempted contact or attempt to influence an evaluator that is involved with this RFA may result in the rejection of this Application and further administrative actions

Evaluation of ApplicationsAll complete Applications that are responsive to the RFA will be evaluated DHHS reserves the right to evaluate Applicants and award funds in a manner utilizing criteria selected at DHHSrsquo discretion and in the best interest of meeting the objectives of the funding involved The Evaluation will be conducted by the following method

DHHS will initially evaluate all Applications to determine whether the Applicant is an eligible entity whether the Application meets the minimum requirements of this RFA and whether the Applicant poses risk of noncompliance with statutes regulations and the terms and conditions of the Grant such that DHHS should not award funding DHHS will award to the top scoring Applicant or Applicants as DHHS determines and as funding allows DHHS will conduct a fair impartial and comprehensive evaluation of all Applications in accordance with the predetermined criteria based on the Application The Applicantrsquos responses to the Forms will be scored through a point method set forth below DHHS will evaluate on the following categories with a maximum point potential for each

1 Applicantrsquos Organizational Overview Applicants will receive high scores if they have a defined and clear organizational structure organizational experience in federal grants qualified and capable personnel with experience in federal grants or equivalent credentials or experience or can otherwise demonstrate that they will be a reliable Grantee who will use all awarded funds in a manner consistent with law and the requirements of this RFA (25 points)

2 Applicantrsquos Work Plan Applicants will receive higher scores if their work plan responds to the Project Description and meets the goals or objectives of the federal funding and RFA as well as evidencing the ability to meet expected outcomes adhere to reporting deadlines or other deadlines and complete any required evaluation activities DHHS exercises sole discretion as to whether the Application adequately addresses the purposes and objectives of the federal funding DHHS has received (100 points)

3 Applicantrsquos Budget Applicants will receive higher scores if the budget is tailored to the work plan and utilizes allowable direct and indirect costs Total request for funding itself will not determine score rather Applicants will be scored based on whether budget accurately reflects allowable costs of completing the work set forth in the work plan (25 points)

4 Additional Requirements Applicants will be evaluated based on responses to section 25 (50points)

There are 200 total points available for Applications under this RFA

DHHS may award to a single top Applicant or may award to multiple top scoring Applicants in its sole discretion If all Applicants meet the minimum requirements and are meritorious DHHS may also elect to award to all Applicants

Late ApplicationsApplications received after the time and date of the Application opening will be considered late Applications Late Applications will be rejected All Applications must be electronically or physically received by the date and time of the Application Opening The State is not responsible for Applications that are late or lost regardless of cause or fault It is the Applicantrsquos responsibility to ensure Applications are received timely

Corrections An Applicant may correct a mistake in an Application prior to the time of opening by giving written notice to the POC of intent to withdraw the Application for modification or to withdraw the Application completely Changes in an Application after the Evaluation Period has begun are acceptable only if the change is made to correct a minor error Whether an error is minor shall be determined by DHHS

Grievance and Protest Procedures All grievances must follow the DHHS Subaward and Grant GrievanceProtests Procedures available on the DHHS website Grievances must be filed timely

10

Competition Joint Efforts Applicants may cooperate or submit Applications jointly but all such Applications must clearly identify the Applicants involved the roles each will have administering the grant and that they are eligible for the grant as set forth herein Applicants may create a legal entity or describe a plan for the creation of a legal entity as a cooperative or joint venture if the entity itself is eligible for the grant and all Applicants are also eligible DHHS shall determine the proper method for any resulting grant should the joint Applicants be selected for funding

DHHS Reservations of Authority During Application and Evaluation Process After Evaluation of the Applications or at any point in the RFA process DHHS may take one or more of the following actions

1 Amend the RFA 2 Extend the time of or establish a new Application opening time (ie allowing additional time to

submit Applications) 3 Waive deviations or errors in the RFA process and in Applications that are not material do not

compromise the RFA process or an Application and do not improve an Applicantrsquos position 4 Accept or reject a portion of or all of an Application 5 Accept or reject all Applications 6 Withdraw the RFA or 7 Elect to reissue the RFA

DHHS reserves the right to adjust the Applicantrsquos budget with successful Applicants after the Intent to Award is issued DHHS also reserves the right to adjust the Work Plan with Applicant to meet the requirements of the grant law or to meet DHHS programmatic needs DHHS also reserve the right to apply additional conditions based on the successful Application and the result of a pre-award risk assessment If a scoring method is used to rank applications to determine funding amounts all adjustments shall have no bearing on rank

If DHHS rejects all Applications it may enter either reissue an RFA with the same or different specifications and terms or it may negotiate a single or multiple Grants with individual Applicants or non-Applicants

11

APPLICATION INSTRUCTIONS

Application ContentsA complete responsive Application must contain the following completed documents

1 Form 1 ndash Application Form and Cover Sheet 2 Organization Overview 3 Applicantrsquos Work Plan 4 Applicant Budget and 5 Responses to section 25

Applications that do not contain all of the required sections will be rejected An editable Microsoft Word-formatted document of the Forms will be posted on the DHHS Website which Applicants may fill in and submit

Applicantrsquos Organizational OverviewThe Applicantrsquos Organization Overview section shall contain the following information about the Applicant If the Application is a cooperative or joint venture between two or more entities all information required in this section shall be provided for all entities even if a new legal entity has been created or is planned to be created for the purposes of the Grant

1 Organization Information Applicantrsquos full legal name including any other ldquodoing business asrdquo names or any previous names the organization used

2 Summary of Federal Grants Experience A description of Applicantrsquos previous experience with receiving federal funds This shall include but not be limited to experience receiving federal funds as a recipient or a Grantee Applicant should describe and demonstrate knowledge of the Uniform Grant Guidance as well as any specific experience with the particular federal program and funding source that funds this RFA

3 Summary of Programmatic Experience A description of Applicantrsquos experience with the type of programming or work contained in the Project Description or other relevant work

4 Personnel and Management Applicant should identify individuals employed by Applicant on its board of directors or otherwise affiliated with Applicant who have a demonstrated knowledge or experience with federal grants the Uniform Grant Guidance programmatic experience or other relevant experience

5 Agreements Terminated or Costs Disallowed Applicant must provide a summary of any agreements executed within the last five (5) years with federal awarding agencies or pass-through entities (either as grant agreements cooperative agreements subawards or contracts) that a Were terminated for cause or b Where Specific Conditions were placed on Applicant (see 2 CFR sect 200207 or 45 CFR sect 75207)

If an Applicant has been disbarred by the United States Federal government it is not eligible to receive funding under this RFA

Applicantrsquos Work Plan The Work Plan must respond in detail to the Project Description It must contain a description of the work activities Applicant is proposing to complete under the RFA It should contain an understanding of the requirements for the project under the applicable state funding sources and as applicable descriptions of timelines outcomeprocess measures and program evaluation activities

Applicantrsquos Budget Each budget should contain only costs that are allowable under the applicable statutes regulations terms and conditions of this RFA Applicants will not be allowed to change their budgets once submitted to DHHS unless the POC specifically requests in writing budget changes Budgets may be modified as required by DHHS or in agreement between DHHS and the Applicant after the Intent to Award is announced Applicants should not rely on budget changes or modifications in submitting their proposed budget but should be able to perform the program activities consistent with their budget If an Applicant has or has prepared a cost allocation plan for this grant it may submit it along with the Application

12

If Applicants plan to charge indirect costs other than through a cost allocation plan Applicants thus must provide one of the following along with their budget 1) A current federally-approved indirect cost rate agreement 2) A currently approved indirect cost rate agreement with DHHS or 3) A calculation of de minimis indirect costs consistent with federal rules DHHS may provide a calculator to aid programs in calculating de minimis indirect costs upon request

Indirect costs and cost allocation plans may also be negotiated after the Intent to Award As consistent with law Applicants may voluntarily opt to take a lower indirect rate than their approved agreement or indirect cost calculation allows

The maximum amount to be awarded per Grantee per region is $40000

13

TERMS Applicants must be aware of the following terms when submitting their Applications These terms will be included in the resulting Grant between the parties as well

Addenda The following Addenda will be incorporated into any Grant with a selected Applicant

1 Addendum A - DHHS Standard Terms ndash State Funds Grant 2 Addendum B - DHHS Insurance Requirements ndash State Funds Grant 3 Addendum C - DHHS Business Associate Agreement Provisions

DHHS reserves the right to amend these terms at any time during the RFA to negotiate the terms with selected Applicants to amend or change these terms for any subsequent Grant signed and executed by the parties or any combination of the above Terms required by federal or state law will not be negotiated and if an Applicant cannot agree to these terms DHHS may withdraw or modify the Intent to Award and take any of the actions set forth herein

Budget ChangesThe final Grant may contain terms to allow a Grantee to modify a budget with or without approval from DHHS Applicants should not however rely on this when submitting budgets

Direct Costs Under this Grant DHHS shall only pay for actual and allowable costs (as defined in this section and the authorities cited herein) incurred during the Period of Performance

To be allowable all costs must be

1 Necessary for the performance of the Grant activities 2 Reasonable as provided in 2 CFR sect 200404 3 Allocable to the federal award as provided in 2 CFR sect 200405 4 Consistent with all other requirements of the Cost Principles in 2 CFR sect 200 Subpart E and 5 Consistent with all other law regulation policy or other requirements applicable to the state or

federal funds involved

To be actual all costs must be finalized and spent by the appropriate dates set forth in the Grant

Applicants should be aware that direct personnel costs must be consistent with 2 CFR sect 200430 as applicable These costs must be able to be backed by sufficient documentation or must be shown to be allocable to the award via an alternative allowable method such as a random moment time study

Indirect Costs Federal law defines indirect costs as ldquocosts incurred for a common or joint purpose benefitting more than one cost objective and not readily assignable to the cost objectives specifically benefitted without effort disproportionate to the results achievedrdquo 2 CFR sect 20056 All indirect costs may only be paid if they are consistent with the UGG

As provided in 2 CFR sect 200414 indirect costs may only be paid from a grant if paid through a federally-approved rate or a rate negotiated between DHHS and the Applicant If the Applicant has never had a federally-approved indirect rate it may charge indirect costs as consistent with the federal rules for de minimis indirect costs

Cost Allocation plans may set forth a direct allocation of all costs under a grant or may allocate only a portion of those costs along with an indirect rate Grantees may not however charge items as direct costs and also as indirect costs

Program Income Any revenue generated by the Grant is Program Income (see definition in 2 CFR sect 20080) Program Income requires an accounting of its use and must be handled in accordance with 2 CFR sect 200307 All program

14

income generated by the Grants awarded as a result of this RFA must be handled under the deduction method Please see the regulations cited above for more detail

Records Retention In addition to any other requirements set forth in this RFA or the resulting Grant the Grantee must comply with the following

1 All records pertaining to each fiscal year of Nebraska Hospital HAP funds must be retained for the greater of 5 years or the period specified below Copies made by microfilming photocopying or similar methods may be substituted for the original records

2 Documentation of each program participantrsquos qualification as a family or individual at risk of homelessness or as a homeless family or individual and other program participant records must be retained for 5 years after the expenditure of all funds from the grant under which the program participant was served

3 Where NHAP funds are used for the renovation of an emergency shelter involves costs charged to the ESG grant that exceed 75 percent of the value of the building before renovation records must be retained until 10 years after the date that ESG funds are first obligated for the renovation and

4 Where NHAP funds are used to convert building into an emergency shelter and the costs charted to the ESG grant for the conversion exceed 75 percent of the value of the building after conversion records must be retained until 10 years after the date that ESG funds are first obligated for the conversion

Faith-Based Activities In addition to any other requirements set forth in this RFA or the resulting Grant the Grantee must comply with the following terms

1 Organizations that are religious or faith-based are eligible on the same basis as any other organization to receive NHAP funds Neither the Federal Government nor a State or local government receiving funds under NHAP shall discriminate against an organization on the basis of the organizationrsquos religious character or affiliation

2 Organizations that are directly funded under the NHAP program may not engage in inherently religious activities such as worship religious instruction or proselytization as part of the programs or services funded under NHAP If an organization conducts these activities the activities must be offered separately in time or location from the programs or services funded under NHAP and the participation must be voluntary for program participants

3 Any religious organization that receives NHAP funds retains its independence from Federal State and local governments and may continue to carry out its mission including the definition practice and expression of its religious beliefs provided that the religious organization does not use direct NHAP funds to support any inherently religious activities such as worship religious instruction or proselytization Among other things faith-based organizations may use space in their facilities to provide NHAP-funded services without removing religious art icons scriptures or other religious symbols In addition an NHAP-funded religious organization retains its authority over its internal governance and the organization may retain religious terms in its organizationrsquos name select its board members on a religious basis and include religious references in its organizationrsquos mission statements and other governing documents

4 An organization that receives NHAP funds shall not in providing NHAP assistance discriminate against a program participant or prospective program participant on the basis of religion or religious belief

5 NHAP funds may not be used for the rehabilitation of structures to the extent that those structures are used for inherently religious activities NHAP funds may be used for the rehabilitation of structures only to the extent that those structures are used for conducting eligible activities under the NHAP program Where a structure is used for both eligible and inherently religious activities NHAP funds may not exceed the cost of those portions of the rehabilitation that are attributable to eligible activities in accordance with the cost accounting requirements applicable to NHAP funds Sanctuaries chapels or other rooms that an NHAP-funded religious congregation uses as its principal place of worship however are ineligible for funded improvements under the program Disposition of real property after the term of the grant or any change in use of the property during

15

the term of the gran is subject to government-wide regulations governing real property disposition (see 2 CFR sectsect 200 et seq)

6 If the recipient or a Grantee that is a local government voluntarily contributes its own funds to supplement federally funded activities the recipient or Grantee has the option to segregate the Federal funds or commingle them However if the funds are commingled this section applies to all of the commingled funds

16

GLOSSARY OF TERMS

All terms shall have the meaning as set forth in 2 CFR sectsect 200 et seq or 45 CFR sectsect 75 et seq unless otherwise specifically set forth herein

AgentRepresentative A person authorized to act on behalf of another

Amend To alter or change by adding subtracting or substituting

Amendment A written correction or alteration to a document

Applicant Non-Federal Entity that has applied for funding under this RFA

Application The written proposal submitted by the Applicant applying for funding under this RFA which is composed of Forms 1 through 5

Application Due Date The date the RFA must be submitted to DHHS and if not submitted by that time rejected

DHHS Website wwwdhhsnegov

Evaluation The process of examining an Applicant after opening to determine the Applicantrsquos responsibility responsiveness to requirements and to ascertain other characteristics of the Application that relate to determination of the successful award

Evaluation Committee Committee(s) appointed by DHHS that advises and assists DHHS in the evaluation of Applications

Evaluator An individual on the Evaluation Committee who advises and assists in the evaluation of Applications

Grant The Agreement executed pursuant to the terms of the RFA between DHHS and the Applicant

Grantee The entity that has executed a Grant with DHHS

HHS Grants Guidance (ldquoHHSGGrdquo) The regulations codified at 45 CFR sectsect 75 et seq a re-codified version of the UGG which provide the general administrative requirements for grant funding flowing down from the federal Department of Health and Human Services See also Uniform Grant Guidance

Intent to Award A document noting the results of the RFA evaluation process and identified any identified Applicant(s) with whom DHHS intends to award federal funds but not a binding agreement with any promise to award

MandatoryMust Required compulsory or obligatory

May Discretionary permitted used to express possibility

Must See MandatoryMust and ShallWillMust

Non-Responsive When an Application does not meet the minimum requirements of this RFA

Point of Contact (ldquoPOCrdquo) The person designated to receive communications and to communicate

Request for Applications (ldquoRFArdquo) Written solicitation of competitive applications for federal grant funding

17

ShallWillMust An ordercommand mandatory

Should Expected suggested but not necessarily mandatory

Uniform Grants Guidance (ldquoUGGrdquo) The regulations codified at 2 CFR sectsect 200 et seq which provide the general administrative requirements for grant funding flowing down from the federal government See also HHS Grants Guidance

Will See ShallWillMust

18

FORM 1 ndash APPLICATION COVER SHEET

Instructions This form must be signed and returned along with the application materials before the Application Due Date to the POC or designated email address as applicable

RFA RELEASE DATE

2634 April 28 2020 APPLICATION DUE DATE POINT OF CONTACT

MAY 26 2020 Keith Roland and Jennifer Crouse

CERTIFICATION AND GUARANTEE OF COMPLIANCE

By signing this Application Cover Sheet the Applicant guarantees compliance with the provisions stated in this Request for Application and certifies that all information contained in this Application is accurate This Application is submitted pursuant to the terms of the RFA and if the Applicant is awarded funding it will be incorporated into the Grant between the parties I understand that if anything in this Application conflicts with the RFA or with the subsequent Grant the Grant and RFA shall govern as set forth in the Grant

ORGANIZATION _________________________________________________________________________

COMPLETE ADDRESS ___________________________________________________________________

_______________________________________________________________________________________

CONGRESSIONAL DISTRICT ____________________

TELEPHONE NUMBER ___________________________ EMAIL ADDRESS ________________________

_____ I CERTIFY THAT THIS ORGANIZATION IS AN ldquoELIGIBLE ORGANIZATIONrdquo AS DEFINED BY THIS RFA

_____ I CERTIFY THAT THIS ORGANIZATION IS NOT PRESENTLY DEBARRED OR SUSPENDED

SIGNATURE ____________________________________________________________________________

TYPED NAME amp TITLE OF SIGNER _________________________________________________________

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